Healthcare Provider Details

I. General information

NPI: 1558811190
Provider Name (Legal Business Name): STEPHEN MICHAEL SCOTT N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 RALEIGH RD
CHAPEL HILL NC
27517-4412
US

IV. Provider business mailing address

1350 RALEIGH RD
CHAPEL HILL NC
27517-4412
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-6800
  • Fax:
Mailing address:
  • Phone: 984-974-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number255629
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5009004
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: